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Sunday, June 26, 2016

Q&A with Mark A. Jacobson

Mark A. Jacobson is the author of the new novel Sensing Light, which focuses on the early years of the AIDS crisis. He is an attending physician at San Francisco General Hospital and a professor of medicine at the University of California San Francisco, and he has specialized in HIV/AIDS.

Q: Why did you decide to write this book, and why as a novel
rather than nonfiction?

A: I’ve always loved reading fiction and, as a young man,
once dreamed of writing a novel that could move people in the way my favorite
authors moved me.

I never committed the effort for such an undertaking until 2008,
after a bicycling accident left me unconscious for several hours. That
experience caused a tectonic shift in attitude toward my own mortality.Instead
of simply comprehending the abstract fact that I wasn’t going to live forever,
I now fully believed that fact, accepted the limits on the time I have left,
and reconsidered my life goals accordingly.

I certainly didn’t want to stop taking care of patients or
teaching medical students and residents in our HIV clinic (and I still don’t),
but I also realized that writing any more grants or research papers wasn’t
going to add substantively to the modest impact I’ve had on the practice of
medicine.

Suddenly, that youthful dream of writing a novel didn’t seem
so impossible. I could imagine a story I was actually well-equipped to tell. I began
gradually winding down my research commitments and developing that story.

In answer to the second part of your question, while I very
much enjoy reading good non-fiction, I don’t feel a passion for writing
it.

Q: How did your own experiences as a doctor during this
period help you create your three main characters?

A: I graduated from medical school and began my internship
in 1981, days after the CDC reported a mysterious, fatal form of
immunodeficiency in five gay men.

A few months later, I was assigned responsibility for the
first patient in my hospital to be diagnosed with this disease. He was
critically ill with Pneumocystis pneumonia, on a ventilator because of
respiratory failure and dialysis for kidney failure. I spent many hours every
day for the next month doing my best to keep him alive and ultimately failed.

That experience and many subsequent ones led to my commitment
to scientific discovery and alleviation of the suffering caused by this disease.
The three protagonists of Sensing Light share a similar experience in the first
part of the novel, which leads to a similar commitment on their part.

To feel the freedom I needed to write this story, I had to
imagine a unique personal history and emotional logic for each character that
had absolutely no basis in the lives or behavior of any of my colleagues during
that time.

However, details from my own life were fair game. I could
distribute many specific challenging situations I had faced among my three
protagonists. Some examples include having a patient plead with me to give him
the means to end his life, a close colleague dying of AIDS, accidentally
sticking myself with a needle contaminated with blood from an HIV-infected
patient, and facing the fury and impossible, yet righteous, demands of AIDS
activists.

Q: The book is set in the first decade of the AIDS epidemic.
Why did you decide not to continue it further into the 1990s and beyond?

A: Sensing Light began as a short story based on my experience
in November 1989, in West Berlin. I had been invited to give a talk at an
international symposium on lung complications of AIDS.

Hours after my arrival, the government of East Germany
collapsed, and thousands of its citizens began streaming across the unguarded
wall into West Berlin. The collective mood was a heady mixture of fear over what
might happen next (Would the East German army invade?) and exhilaration (The
Cold War had just ended!).

After writing this story, in which the protagonists are
American doctors attending this symposium, I began working backwards, imagining
these characters’ lives and interactions before the drama in Berlin occurs.Continuing the story after Berlin, other than
with a brief epilogue, would have been anti-climactic.

Q: What do you hope readers take away from the novel?

A: Albert Camus said this so eloquently that I will defer to
him.“What we learn in a time of
pestilence is that there are more things to admire in men than to despise.”

Q: What are you working on now?

A: Another novel, more ambitious in historical scope and aiming
for more narrative suspense and complex character development than Sensing
Light did, but employing just a single protagonist—someone with a minor role in
Sensing Light as one of Kevin’s junior faculty protégés.

I want to grow as a writer by creating empathy for a
character who has a more troubled past and is more susceptible to moral
compromise than any of the protagonists in Sensing Light.

Q: Anything else we should know?

A: AIDS no longer needs to be the fatal disease it was in Sensing
Light.Simply by testing everyone at
risk for having HIV infection and treating those who test negative with a
single antiretroviral pill daily, we can end HIV transmission and ultimately its
associated illness and mortality.

Even those already infected with HIV can have lives of
normal duration and health by adhering to modern antiretroviral drug regimens,
just as people with diabetes can by controlling their blood sugar with diet and
medication. Treating those already infected also greatly reduces their risk of
transmitting the virus!

About Me

Author, THE PRESIDENT AND ME: GEORGE WASHINGTON AND THE MAGIC HAT, new children's book (Schiffer, 2016). Co-author, with Marvin Kalb, of HAUNTING LEGACY: VIETNAM AND THE AMERICAN PRESIDENCY FROM FORD TO OBAMA (Brookings Institution Press, 2011).